Diabetes and Social Security Disability Insurance

Here is an explanation of Social Security's five-step process to determine if a diabetes patient qualifies for SSDI:

1.  Determine if an individual is "working (engaging in substantial gainful activity)" according to the SSA definition. Earning more than $940 a month as an employee is enough to be disqualified from receiving Social Security disability benefits.

2.  Conclude the diabetes disability must be severe enough to significantly limit one’s ability to perform basic work activities needed to do most jobs. For example:

• Walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling
• Seeing, hearing and speaking
• Understanding/carrying out and remembering simple instructions
• Responding appropriately to supervision, co-workers and usual work situations
• Dealing with changes in a routine work setting

3.  Diabetes mellitus (DM) is listed under the category of impairments known as the Endocrine System – Medical Listing 9.08. The following criteria have been established indicative of the inability to engage in any substantial gainful activity, i.e., if one has a diagnosis of diabetes mellitus and one of the following, a finding of disabled under the Social Security Act is warranted:

• Neuropathy demonstrated by significant and persistent disorganization of motor function in two extremities resulting in sustained disturbance of gross and dexterous movements, or gait and station.
• Acidosis occurring at least on the average of once every two months documented by appropriate blood chemical tests (pH or PCO2 of bicarbonate levels).
• Retinitis Proliferans is evaluated under the criteria established for visual impairments, i.e., visual acuity in the better eye is 20/200 or less, visual field contraction and loss of visual efficiency.

4.  Explore the ability of an individual to perform work they have done in the past despite their diabetes. If the SSA finds that a person can do his past work, benefits are denied. If the person cannot, then the process proceeds to the fifth and final step.

5.  Review age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform. To determine diabetes disability, the SSA enlists medical-vocational rules, which vary according to age.

For example, if a person is:

Under age 50 and, as a result of the symptoms of diabetes, unable to perform what the SSA calls sedentary work, then the SSA will reach a determination of disabled. Sedentary work requires the ability to lift a maximum of 10 pounds at a time, sit six hours and occasionally walk and stand two hours per eight-hour day.

Age 50 or older and, due to the diabetes, limited to performing sedentary work, but has no work-related skills that allow him to do so, the SSA will reach a determination of disabled.

Age 55 or older and, due to the disability, limited to performing light work, but has no work-related skills that allow him to do so, the SSA will reach a determination of disabled.

Over age 60 and, due to the diabetes, unable to perform any of the jobs he performed in the last 15 years, the SSA will likely reach a determination of disabled.

Any age and, because of diabetes, has a psychological impairment that prevents even simple, unskilled work, the SSA will reach a determination of disabled.

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